Tuesday, April 17, 2012

Reality Check (The Cost/Benefit Analysis of Breastfeeding)

L is 6 months and 12 days old and we are still exclusively breastfeeding (we have tried solids...despite reaching & grabbing for our food for months, he is not keen on actually eating any of it and much barfing has ensued). So I suppose you would call our "breastfeeding relationship" a success.  We feed in the morning and evening every day; throughout the day on weekends/holidays. I pump about 1/2-2/3 of what L gets by bottle each weekday (he gets 18 oz at daycare, plus up to 4 oz bottle at night if still hungry after nursing). The rest comes out of the dwindling freezer stash. Sometimes the pumping, and the anxiety about supply, and...lots of things, really...get to me, and I am enraged by the whole: "Its free and convenient!" breast-is-best mantra. So indulge me while I unburden myself of 6 months of observations I've gathered about the realities of breastfeeding. Maybe it should go without saying, but I'll say it anyways: these observations are my own and apply only to my specific situation/personality...I am not trying to discourage/encourage anyone towards a specific way of feeding their baby.

Financial: Free! Ha! I actually calculated this with B, and given the upfront costs of breastfeeding, the savings of avoiding formula wouldn't kick in until 6 months. Given my early breastfeeding difficulties, my costs were substantially higher than others: Lactation visit at doctor $120, Home lactation visit 10 days later when I was about to give up: $150 (and that was with a discount because she felt sorry for me!), breastpump: $300 (with 20% off coupon!) + $50+ for extra flanges, parts, etc... Over $100 in freezer bags so far, Over $100 in nursing pads, soothie gel pads, nipple shields, lanolin. Already $100 in herbs for supply-boosting. 5 nursing bras at approximately $40/each=$200. I'm probably forgetting stuff, but you get the point. That would buy a LOT of formula. Plus we had to buy bottles anyways, for when I'm at work. Oh yeah, and all the extra food & snacks I'm eating? Probably a HUGE money suck, since I rarely plan well enough to bring what I need from home and end up buying overpriced snacks at work.

Convenience: A LOT to say here, so I'll break it into sub-categories.
  • BFing in Public: Yes, when I'm at home or in a seated/private location somewhere with the baby, there is nothing more convenient than just feeding him when he's hungry. But how often is that? Something I didn't think about was how difficult it is to breastfeed in winter clothes. Most of our outings when L was wee were taking big brother to the park. It was winter. Mild, but still requiring a coat & uncomfortable to strip off coat & layers...and would draw a LOT of attention, I'm sure. So I had to pump & take a bottle. Not everywhere has an appropriate place to feed, I've had to go out to the car or a nurse in a bathroom at times. At the beginning, L had a LOT of trouble latching and I needed both hands to help him, so it was difficult to cover up or be discreet. Now that's better, and I cover us with a blanket---but its getting too hot for a blanket so now what? 
  • Pumping: It is disruptive and time-consuming at work and is definitely affecting my ability to get things done, especially long experiments with specific time points that you can't just switch around. When doing clinical work, forget it. I pump when/if I can and hope I don't leak/dry up in the process.
  • Siblings: Since I've got the equipment, when we divide and conquer children, I get L. This definitely caused resentment from B early on and even now at times. It is also logistically difficult to tend to B's needs while L is glued to my chest, or worse, when I need to pump. I've wanted to spend a day with B just the two of us, but if L isn't with me, I'd have to pump---how would I work that out?
  • Timing/Getting Away: Because of wanting to keep my supply up & protect my precccciiiioouus freezer stash, I have declined any traveling (and chances to present my work and add to my CV) and very very rarely go to any evening events---even the monthly ones touted by our chief as "great networking opportunities". I have to time any outings carefully around feeds on the weekends, or bring L with me, because I don't want to pump during the day. I have skipped book club & other social opportunities so I didn't have to work out pumping/feeding logistics. I pump one side EVERY morning (including weekends), which adds another complexity to our crazy morning routine, and taking time to pump & feed before I can go on my run cuts way into my potential running time.Now that its hot out, I will have to hurry STRAIGHT home from work with the pumped milk (which I keep in the fridge at work), no summer happy hours or park trips.
  • Clothing: Yes, this is frivolous, but I like clothes & dressing a certain way. I can't wear a LOT of my clothes because they just aren't convenient for nursing or pumping. You cannot pump in a dress unless it had functional buttons on the top, which eliminates a lot of my favorite summer outfits. When I'm already feeling fat & unsexy, having to wear loose button downs or clingy (in the wrong places) knits with stretched out necklines is just the icing on the crap-cake.

Physical Health: 
  • Baby: I've realized in retrospect that L's poor weight gain & extreme fussiness was due, at least partly, to my decreasing supply. Once we started giving him more than what I'd pumped the day before, he perked up & plumped up. But breastfeeding makes the diagnosis/treatment trickier, since you have literally no idea how many calories are coming in...it made the whole thing take longer & poor L suffered. Of course there are the potential health benefits of breastmilk. My anecdata (n=2) show no protection from illness/infection but no one will thankfully ever be able to see what L got & B didn't. 
  • Mom: I am really lucky in this regard, I don't have any chronic illness or condition that I have to leave untreated because of breastfeeding. I don't have to avoid any foods because L is allergic. I've known mothers that had really rough time it; my biggest issue was not being able to take decongestants when I had a sinus infection. I have had to limit exercise and limit any calorie restriction because I noticed a major drop in supply---so I guess my "healthiness" may be impacted a bit, who knows. There may be potential beneficial effects that offset that. 
Mental Health: It is really satisfying to be the sole source of nourishment for your child...but with that great power comes great responsibility. The anxiety I felt when L wasn't gaining weight, knowing it my failing boobs that were the culprit... I still stress over every drop. One might say I am a bit CRAZY about it...I will save 1/2 oz bottles...I found frozen milk more than 3 months old and decided, meh, can't hurt and used it anyways...I begrudge every spit-up and vomit and practically cry over spilled milk. As much as I logically know that supplementing with formula is fine and have no judgement against anyone that uses it (I've done it myself and  I KNOW IT IS FINE) I just can't turn off the internal pressure telling me that "formula=failure, breastmilk=success". Its really a craziness; I see it in lots of bf-ing mothers...I must name it and get it on the DSMIV. It must be the hormones.

      On the upside, I quite simply enjoy nursing L. Its actually a nice excuse to sit down (usually) and browse blogs or just be. The positioning isn't conducive to really interacting with L, but its nice to snuggle & the sleepy milk-drunk grins when he's done...priceless. I will miss this. This is what makes it worthwhile.


  1. Yep. I diagnose myself with that disease in retrospect - and I am really afraid I will suffer from it this time around as well.

    This post is important and I think it is the unspoken side of "breast is best". Lesley from http://theordinaryadventure.blogspot.com/ linked to this article about a month ago:


    I think that few people understand that going back to work while breastfeeding means a pretty damn difficult time for mom. However, this is given as the reason that some countries (Canada, I believe - and several European countries) provide an extended maternity leave. I know that leave has it's costs as well, career-wise.

    1. Thanks, as always, for your thoughtful comment! I have read that article & didn't include it in this post because I wanted to focus on things I directly observed for myself & also because I am skeptical that they could really avoid all the confounders involved in the study...what if women who chose to breastfeed deliberately cut their hours/productivity simply because they wanted to re-prioritize. Yes, that leads to less earning potential, but that may have been a deliberate choice, not an unforeseen negative consequence.
      Thankfully these crazies are time-limited and don't require extensive treatment...

    2. I breastfed for 13 months, and I can attest that breastfeeding is no easy feat. I remember the first few days as torture; everything hurt, and I had no time because I was constantly nursing. I remember I would look up benefits of breastfeeding every day just to convince me to continue going.

      I also had to pump, and the bags and bottles did get expensive and time consuming to clean. Thankfully I didn't have to spend money on a consultant so my costs were mostly the pump and materials.

      If I were to do this again I would still breastfeed because the benefits really do have me convinced, but that said, it is absolutely not easy. I felt complete freedom once my baby was weaned (obviously sad that he was grown up and that I couldn't hold him like this anymore, but overall I was much happier).

    3. Thanks for your comment sleeping mom. Yes, the first days (weeks for us) were torture indeed! Good for you for going so long. I'd definitely do it again, also, but don't think I'm going to have the opportunity.

  2. Great post! I nodded my head throughout, but particularly at the end. I think other benefits aside, I did it because I enjoyed the experience, and I'm just grateful it was easy (after the hellish early weeks...) so that I didn't have a whole lot of conflict about it. I'm glad I can still nurse in the mornings, but love love loving not having to pump! And not too broken hearted about weaning in a few weeks.

    1. Not having to pump, sounds DIVINE. But I do enjoy it, all that complaining aside, and it is SO EASY when I'm home with L. Its